17 Feb, 09 | by BMJ
While teaching two courses on “getting published” in Dhaka I had a marvellous opportunity to gather insights into why researchers from a low income country have problems writing and getting published. Most of the researchers were juniors from ICDDR, B (formerly the International Centre for Diarrhoeal Disease Research, Bangladesh), a well established and highly successful research institute. The courses were very lively and lots of fun – for me at least. There were about 60 participants on the first day and 30 on the second.
The classes produced many compelling reasons for publishing, and the students knew exactly what editors want. Why then were they not writing and publishing more? Each class produced a great many reasons, and then we ranked them – by giving everybody two votes.
The overall conclusion has to be that there is not one reason but many, and the importance of those reasons for not publishing varies from individual to individual. It might also have been that if we had dug deeper to find the real reasons we might have come up with a different set.
High on the list of both classes was poor access to journals and the internet. Everybody did, however, have internet access – albeit often slow. And Bangladesh has been one of the most enthusiastic countries in taking up free access to journals through the HINARI scheme. So perhaps it’s less that the researchers don’t have access but more that they don’t have a culture of regular reading. “Little culture of writing” was cited as a reason for not publishing more–but received few votes.
A Harvard economics professor who attended part of one class because he had trouble getting published in medical journals told me that economists pay no attention to what people say but only to what they do. Doctors, for example, say that they are not influenced by money or advertising but clearly they are. The relevance here is that I asked all of those attending the course to “publish something, anything within 48 hours” and email me a copy of what they published. So far – more than 48 hours after both of my courses – I’ve had nothing, whereas 10 out of 26 Dutch general practitioners completed the same assignment.
Perhaps people are scared. For a professional loudmouth like me blogging is no big deal, but for many people it’s a very bold step to press a button and potentially let the whole world read what you’ve written. “Fear of criticism and rejection” and “lack of confidence” came high on our list of reasons for not writing and publishing, and these anxieties may be particularly acute if you work in a hierarchical culture – which is often the case in low income countries.
Another problem was “not knowing where to submit studies.” They asked me how they could know. I reflected and realised that “instructions to authors” would be mostly useless: journals are not usually specific about what they like and don’t like. You can pick up this information only by having regular contact with the journals, and journals change over time, particularly as editors change. This is tacit knowledge that is hard to come by, and tacit knowledge and skills may be very important in getting published. I think of my father trying to teach me to drive and being completely incapable of describing what was involved: he just did it.
Perhaps it was tacit knowledge the classes wanted when they categorized “lack of knowledge of scientific writing” as an important reason for failure to publish. I gave them some of the standard material on how to write a paper, but I doubt that it’s nearly enough. People need mentors to help them, people who can be beside them day after day helping them line by line. Such mentors are in short supply, and “lack of mentors” was on our list.
“Hard to get started” was another problem, one that most writers will recognize. There is always something else to do – answer an email, make a cup of coffee, ring your dentist, anything to avoid the potential pain of trying to write. I wish that there was a writing equivalent of asking people to draw blindfold. The closest I could come was to ask everybody to write 200 words on anything in 10 minutes. They all did, and nobody said they disliked the experience. Indeed, most liked it a lot, and many wrote something that was compelling. Everybody has a story to tell.
“Time and workload” were other reasons, but I don’t think them important. Rather they are all purpose excuses – like lack of money.
“Having to write in English” was one of the first reasons called out in both classes, but it received few votes. As in India, medical students in Bangladesh are taught in English, and people told us that doctors who are sent a journal with articles in both English and Bangla (which is the same as Bengali) chose to read the English versions. There was also agreement that it’s easier to write scientific articles in English because Bangla lacks a scientific vocabulary.
There was disagreement about discrimination as a problem in getting published. Some thought that there was discrimination against young authors and authors from low income countries, but it wasn’t ranked as a major reason.
In addition to problems writing there were also problems with methodology, getting data analysed, and disputes over ownership of data, but we were now beginning to descend into the less serious reasons that included “aiming too high, lack of enthusiasm, laziness, and complacency.” One Nepalese student summed it all up by saying that writing produced a “low return for all the investment.” What I asked about career advancement, fame, money, and the love of beautiful women? “There are,” he answered, “much easier ways to get those things.” Perhaps that’s the real reason for not writing and publishing.
Competing interests: The UnitedHealth Chronic Disease Initiative that RS directs is funding the creation of a centre to counter chronic disease at ICDDR, B. RS had his fare to Dhaka paid by ICDDR, B because he delivered the keynote address at its scientific conference. Overnight trips in Emirates economy via Dubai would not, however, count as a bribe in anybody’s book. He also had his stay in the guest house funded and his ticket to the Black and White Ball, both of which were very pleasant. He wasn’t paid for running the courses despite quoting Samuel Johnson in the courses as having said “Only a fool writes for any reason apart from money.” He isn’t being paid for this blog either.”